Dental
Thometz, Karissa
Thometz, Karissa was paid $121K by Medicaid between Aug 2023 and Dec 2024, across 13 billing codes. Its largest line is D1120, dental cleaning, child — 23% of everything it billed.
33Billing provider infoTHOMETZ, KARISSA
COTTONWOOD HEIGHTS, UT 84047
COTTONWOOD HEIGHTS, UT 84047
33aNPI1639868011assigned 05/02/2023
33bProvider typeGeneral Practice Dentistry
28Total paid$121K
24GClaims4,319
24DCodes billed13
24AFirst – last monthAug 2023 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Utah
Rank by total paid#52 of 225
Median peer was paid$21K
This provider vs. median5.7×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2023 | 1,567 | $50K | |
| 2024incomplete | 2,752 | $71K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 23% | 616 | 616 | $28K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 614 | 614 | $18K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 14% | 178 | 81 | $17K |
| D0230 | Intraoral - periapical each additional radiographic image | 12% | 1,134 | 561 | $14K |
| D1206 | Topical application of fluoride varnish | 11% | 660 | 660 | $14K |
| D0220 | Intraoral - periapical first radiographic image | 8.0% | 599 | 592 | $10K |
| D0274 | Bitewings - four radiographic images | 6.1% | 178 | 178 | $7K |
| D0272 | Bitewings - two radiographic images | 3.9% | 169 | 169 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.1% | 95 | 95 | $4K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.6% | 25 | 13 | $2K |
| D1110 | Prophylaxis - adult | 1.3% | 26 | 26 | $2K |
| D0330 | Panoramic radiographic image | <1% | 12 | 12 | $759.10 |
1 more codes
| D0140 | Limited oral evaluation - problem focused | <1% | 13 | $436.15 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.